A Systematized Scoping Review on the Effect of Oncoplastic Surgery on arm Lymphedema

Background: With 2.3 million new breast cancer cases globally in 2020 and advances in treatment, the focus has shifted to managing long-term complications such as arm lymphedema. While oncoplastic breast surgery is increasingly used to enhance cosmetic outcomes, its effect on arm lymphedema remains unclear. However, the manipulation of breast tissue and increased vascular and lymphatic disruption raise concerns regarding an elevated risk of postoperative lymphedema. This scoping review explores the existing literature on oncoplastic breast surgery and arm lymphedema. Methods: This review is part of a systematic review registered in PROSPERO, focusing on lymphedema outcomes. The systematic search identified 4,185 publications, with four studies meeting the inclusion criteria for oncoplastic surgery and arm lymphedema. Transforming to a scoping review, an extra study was included, totaling five studies. Data were extracted on study design, population, type of surgery, lymphedema measurement, and risk factors. Citations and screening were managed using Covidence. Results: The five studies included 1,532 patients with follow-up periods ranging from 12 months to 7.4 years. Lymphedema rates for OBCS varied between 0% and 11%, with an overall rate of 6.7%. Conclusion: Due to inconsistent reporting and a lack of long-term follow-up data, no definitive conclusions regarding the risk of arm lymphedema related to oncoplastic breast surgery could be drawn. Future prospective studies with standardized lymphedema measurements and specific evaluations of oncoplastic breast surgery techniques are needed. Addressing these gaps is crucial for improving patient outcomes and guiding clinical decisions.